Chloramex Ophthalmic is an eye ointment containing chloramphenicol 1%. It is used for bacterial eye infections — most commonly bacterial conjunctivitis — and for infected eyelid margins. It treats bacteria only, so it does nothing for viral or allergic conjunctivitis, which are far more common causes of a red eye.
What is Chloramex Ophthalmic?
Chloramex is registered in South Africa as Schedule 4 — prescription-only:
| Product | Contains |
|---|---|
| Chloramex Ophthalmic Ointment 3.5 g | Chloramphenicol 10 mg/g (1%) |
Chloramphenicol is a broad-spectrum antibiotic. It binds to the bacterial ribosome and blocks protein synthesis, so the bacterium cannot make the proteins it needs to grow and divide. Human ribosomes differ enough for the effect to be selective.
Applied to the eye, it stays largely where it is put. Very little is absorbed into the body, which matters because chloramphenicol taken systemically carries a rare but serious risk of aplastic anaemia — a bone marrow failure. That risk is associated with systemic use, and topical eye preparations are widely used precisely because exposure is minimal. It is worth knowing about, not worth being alarmed by.
Ointment or drops? Both exist, and the difference is practical:
- Ointment stays in contact longer, so it needs applying less often and suits night-time use. It blurs vision for a period after application — which is why it is often used at bedtime.
- Drops do not blur vision, but wash out faster and need more frequent application.
Many people use drops during the day and ointment at night.
What is Chloramex Ophthalmic commonly used for?
A doctor may prescribe it for:
- Bacterial conjunctivitis — the main use. Typically a red, gritty eye with sticky yellow or green discharge, often gluing the lashes together on waking, and frequently affecting both eyes.
- Blepharitis, inflammation of the eyelid margins, where bacteria contribute.
- Styes and infected eyelid glands, in some cases.
- Corneal abrasions, to prevent infection while the surface heals.
- Preventing infection after minor eye injury or a foreign body.
- Before or after eye surgery, on specialist direction.
It treats bacterial infection only. It will not help:
- Viral conjunctivitis, which is far more common than bacterial. Typically watery rather than sticky discharge, often with a recent cold or sore throat, and frequently starting in one eye. It resolves on its own, usually over one to two weeks.
- Allergic conjunctivitis — itchy, watery, both eyes, often seasonal and with sneezing. This needs an antihistamine, not an antibiotic.
- Dry eye, which needs lubricating drops.
Most conjunctivitis is not bacterial, and much of it resolves without treatment. That is worth knowing, because an antibiotic used for a viral or allergic red eye achieves nothing and drives resistance.
How Chloramex Ophthalmic fits into this medicine category
| Group | Examples | Used for |
|---|---|---|
| Topical eye antibiotics | Chloramphenicol (Chloramex), fusidic acid | Bacterial eye infections |
| Topical antihistamines | Antazoline, olopatadine | Allergic conjunctivitis |
| Lubricating drops | Hypromellose, carbomer | Dry, gritty eyes |
| Topical steroids | Prednisolone eye drops | Inflammation — specialist use only |
| Topical antivirals | Aciclovir eye ointment | Herpes eye infections |
| Skin antibiotics | Mupirocin | Skin, not eyes |
Steroid eye drops deserve a specific warning. They must never be used for a red eye without an eye examination — in a herpes eye infection they can cause rapid, sight-threatening damage. Do not use anyone else’s eye drops, particularly if you do not know what they contain. See the skin and wound care medicines hub.
What to check before using Chloramex Ophthalmic
Wash your hands before and after applying. Conjunctivitis is highly contagious, and hands are how it spreads — to your other eye, and to other people.
Do not let the tube tip touch your eye, eyelid or anything else, which contaminates it.
Do not wear contact lenses during treatment, or until the infection has cleared and your doctor says it is safe. Lenses can worsen the infection and absorb the medicine. Discard the lenses you were wearing when the infection started.
Do not share the tube, and discard it after the course — commonly within about four weeks of opening.
Vision will blur for a period after applying ointment. Do not drive until it clears.
Tell your doctor or pharmacist if you:
- Have any personal or family history of blood disorders, particularly aplastic anaemia, or previous bone marrow problems.
- Have had a reaction to chloramphenicol before.
- Are pregnant or breastfeeding.
- Are treating a baby or young child.
- Wear contact lenses.
- Have glaucoma, or any existing eye condition.
- Have had recent eye surgery or injury.
- Use other eye preparations — separate them by several minutes, and apply ointment last.
Possible cautions and when to ask a pharmacist or doctor
Common effects are temporary stinging or burning on application, blurred vision, and mild irritation. These usually settle within a minute or two.
Stop and seek medical attention if you develop:
- Increasing redness, swelling, itching or discharge — this may be a reaction to the medicine rather than the infection worsening.
- Swelling of the face, lips or tongue, a widespread rash, or difficulty breathing.
- Unusual bruising, bleeding, persistent sore throat or fever, or unexplained tiredness — report these, given the blood disorder association.
Seek medical attention urgently — the same day — for any of these red flags:
- Pain in the eye, as opposed to grittiness or discomfort.
- Reduced or blurred vision that does not clear after the ointment settles.
- Sensitivity to light (photophobia).
- A red eye with a headache, nausea or vomiting — possible acute glaucoma.
- Redness concentrated around the coloured part of the eye.
- A pupil that looks different in size or shape.
- Swelling, redness or pain around the eye socket or eyelid, particularly with fever — possible orbital cellulitis, which is serious.
- A red eye following an injury, or where something may have entered the eye.
- A red eye in a newborn, which needs urgent assessment.
- No improvement after 48 hours, or worsening at any point.
- Contact lens wearers with a red, painful eye — this needs prompt assessment, as lens-related corneal infection can threaten sight.
A painful red eye with reduced vision is not conjunctivitis until proven otherwise. Conjunctivitis is uncomfortable and gritty; it does not usually hurt or affect vision.
Related medicine guides
Frequently asked questions
What is Chloramex ophthalmic ointment used for? Bacterial eye infections, most commonly bacterial conjunctivitis, and infected eyelid margins. It contains chloramphenicol 1%.
Will it help a red eye? Only if the cause is bacterial. Viral and allergic conjunctivitis are more common and do not respond to antibiotics.
How do I tell bacterial from viral conjunctivitis? Bacterial typically has sticky yellow or green discharge gluing the lashes; viral is usually watery, often follows a cold, and resolves on its own. A doctor can distinguish them.
Why does it blur my vision? Ointment coats the eye surface, which blurs vision briefly. That is why it is often used at bedtime. Do not drive until it clears.
Can I wear contact lenses? No, not during treatment. Discard the lenses worn when the infection started, and wait until your doctor says it is safe.
Is chloramphenicol dangerous? The serious blood disorder associated with chloramphenicol relates to systemic use. Eye preparations involve minimal absorption, but tell your doctor of any blood disorder history.
How long should I use it? For the course prescribed, usually continuing a couple of days after symptoms clear. Seek review if there is no improvement in 48 hours.
When is a red eye an emergency? With pain, reduced vision, light sensitivity, a differently shaped pupil, after injury, in a newborn, or in a contact lens wearer. Seek same-day care.